March 12, 2015
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80% adherence to colorectal cancer screening could prevent 200,000 deaths by 2030

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If 80% of Americans underwent recommended colorectal cancer screening, nearly 280,000 new cancer cases and more than 200,000 cancer deaths could be prevented during the next 15 years, according to results of a modeling study.

“Despite the effectiveness of screening and the availability of various screening options, only 58% of U.S. adults aged 50 to 75 years had received guideline-recommended testing in 2013,” researcher Reinier G.S. Meester, MS, of the department of public health at Erasmus MC University Medical Center, and colleagues wrote. “Previous studies have demonstrated that a substantial percentage of colorectal cancer deaths are attributable to nonuse of screening. This rallied a recent initiative from the National Colorectal Cancer Roundtable (NCCR), a national coalition of public, private and voluntary organizations, to aim for screening rates of 80% in the United States by 2018.”

Meester and colleagues used microsimulation modeling to estimate the potential health impact of reaching the NCCR’s goal of 80% colorectal cancer screening compliance rates by 2018.

Researchers simulated a population of men and women aged 50 to 100 years who replicated the 1980 to 2030 U.S. population with regard to life expectancy, colorectal cancer risk, and past or future screening use with colonoscopy, fecal occult blood tests and sigmoidoscopy.

If screening rates continued at approximately 60% from 2014 to 2030, the crude incidence of colorectal cancer would increase from 137 cases per 100,000 individuals to 149 cases during that time due to the aging population, results showed. Under that scenario, colorectal cancer mortality would increase from 44 deaths per 100,000 individuals in 2014 to 28 per 100,000 individuals in 2030.

If colorectal cancer screening uptake increased to 80% by 2018, colorectal cancer incidence initially would increase due to early detection among previously unscreened individuals, but it ultimately would decline 22% by 2030. This reduction would help prevent 277,000 colorectal cancer cases between 2013 and 2030, results showed.

Under the increased screening scenario, colorectal cancer mortality rates would decrease from 43 deaths per 100,000 individuals in 2014 to 32 deaths per 100,000 individuals in 2030. This would translate into 21,000 deaths averted yearly, or 203,000 deaths averted by 2030.

Researchers also determined that 80% screening rates would decrease the number of under-screened individuals in the U.S. by approximately half.

“There are many barriers to increasing colorectal cancer screening uptake in the United States, only some of which are the target of health care reforms under the Patient Protection and Affordable Care Act,” Meester and colleagues wrote. “Substantial coordinated effort is needed to achieve the goal of an 80% colorectal cancer screening rate by 2018 in the United States. The results of the current study indicate that such investments may be well rewarded with long-term reductions in colorectal cancer incidence and mortality … in [less than] 20 years.” – by Cameron Kelsall

Disclosure: One researcher reports a paid consultancy role with Exact Sciences. The other researchers report no relevant financial disclosures.